BackgroundNutritional requirements are increased during pregnancy and lactation. The aim of this study was to compare the food intake and prevalence of inadequate nutrient intake among pregnant, lactating and reproductive-age women.MethodsTwo-day dietary records of 322 pregnant and 751 lactating women were compared to those of 6837 non-pregnant and non-lactating women aged 19 to 40 years from a nationwide representative sample. The usual nutrient intake was estimated using the National Cancer Institute method, and compared to nutritional goals to estimate prevalence of inadequate intake.ResultsPregnant, lactating and reproductive-age women did not differ in their average consumption of 18 food groups, except for rice, with greatest intake among lactating women. The prevalence of nutrient inadequacy in pregnant women was higher than in reproductive-age women for folate (78% versus 40%) and vitamin B6 (59% versus 33%). In lactating women, prevalence was higher than in reproductive-age women for vitamin A (95% versus 72%), vitamin C (56% versus 37%), vitamin B6 (75% vs. 33%), folate (72% versus 40%) and zinc (64% versus 20%). The percentage of sodium intake above the upper limit was greater than 70% in the three groups.ConclusionsInadequate intake is frequent in women and increases during pregnancy and lactation, because women do not change their food intake. Guidelines should stimulate healthy food intake for women across the lifespan.

Because eating habits are inseparably linked with people’s physical health, effective behaviour interventions are highly demanded to promote healthy eating among older people. The aim of this systematic review was to identify effective diet interventions for older people and provide useful evidence and direction for further research. Three electronic bibliographic databases—PubMed, Scopus and Web of Science Core Collection were used to conduct a systematic literature search based on fixed inclusion and exclusion criteria. English language peer-reviewed journal articles published between 2011 and 2016 were selected for data extraction and quality assessment. Finally, a total of 16 studies were identified. The studies’ duration ranged from three weeks to seven years. The majority of studies were carried out in European countries. Seven studies had a moderate quality while the remaining studies were at a less than moderate level. Three dietary educational interventions and all meal service related interventions reported improvements in older people’s dietary variety, nutrition status, or other health-related eating behaviours. Multicomponent dietary interventions mainly contributed to the reduction of risk of chronic disease. The results supported that older people could achieve a better dietary quality if they make diet-related changes by receiving either dietary education or healthier meal service. Further high-quality studies are required to promote healthy eating among older people by taking regional diet patterns, advanced information technology, and nudging strategies into account.

A quasi-experimental study was designed to promote novel plant-based dishes using the nudging strategy 'dish of the day' among older consumers in Denmark, France, Italy and the United Kingdom. Participants were presented with three dish options: veggie balls, meatballs and fish cakes. In the intervention situation, participants were informed that the 'dish of the day' was the novel plant-based 'veggie balls'. Thereafter, participants were asked to choose one of three dishes to intake and then fill a questionnaire. No statistically significant difference in dish choice was found between the control group and intervention group in the four countries. Males were less likely to choose the plant-based dish when compared with the females. Participants from the United Kingdom and Denmark were more likely to choose the plant-based dish when compared with participants from France. High scores of security dimension from the Human Value Scale was negatively associated with choice of plant-based dish, while high scores of the sensory dimension from Food Choice Questionnaire and high scores of the universalism dimension from Human Values Scale were positively related to the choice of the plant-based dish. The 'dish of the day' nudging approach did not influence older people's plant-based dish choice. Gender, country, and dimensions of sensory, universalism and security were critical factors influencing an older people's plant-based food choice.

To test the impact of a nudge strategy (dish of the day strategy) and the factors associated with vegetable-dish choice, upon food selection by European adolescents in a real foodservice setting. Methods: A cross-sectional quasi-experimental study was implemented in restaurants in four European countries: Denmark, France, Italy and United Kingdom. In total, 360 individuals aged 12-19 years were allocated into control or intervention groups, and asked to select from meat-based, fish-based, or vegetablebased meals. All three dishes were identically presented in appearance (balls with similar size and weigh) and with the same sauce (tomato sauce) and side dishes (pasta and salad). In the intervention condition, the vegetable-based option was presented as the "dish of the day" and numbers of dishes chosen by each group were compared using the Pearson chi-square test. Multivariate logistic regression analysis was run to assess associations between choice of vegetable-based dish and its potential associated factors (adherence to Mediterranean diet, food neophobia, attitudes towards nudging for vegetables, food choice questionnaire, human values scale, social norms and self-estimated health, country, gender and belonging to control or intervention groups). All analyses were run in SPSS 22.0. Results: The nudging strategy (dish of the day) did not show a difference on the choice of the vegetable-based option among adolescents tested. However, natural dimension of food choice questionnaire, social norms and attitudes towards vegetables nudging were all positively associated with the choice of the vegetable-based dish. Being male was negatively associated with choosing the vegetable-based dish. Conclusions: The "dish of the day" strategy did not work under the study conditions. Choice of the vegetablebased dish was predicted by natural dimension, social norms, gender and attitudes towards vegetables nudging. An understanding of factors related to choosing vegetable-based offers an important tool for the development and implementation of public policy interventions aiming to increase the consumption of vegetables among adolescents.

Objectives: Complementary feeding should provide a healthy diet with critical nutrients for growth and development. Information is limited on child and infant feeding recommendations within the World Health Organization (WHO) European Region. Methods: The WHO Regional Office for Europe and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) performed a survey of national recommendations on infant and young child nutrition aimed at national government departments of health and national paediatric experts. Questions addressed national recommendations on breast-feeding and complementary feeding. Results: Information was available from 48 of the 53 Member States. Forty-five of 48 countries (94%) have national recommendations on infant and young child feeding, of which 41 are endorsed by official public health authorities. Regarding introduction of complementary feeding, 25 countries (out of 34, 74%) recommend 6 months of age as the ideal age. The earliest age of introduction recommended varies from 4 to 5 months in (31/38 countries, 82%) to 6 months (6/38, 16%) and 7 months (1/38, 2.6%). The recommended meal composition varies widely; introduction of iron-rich foods (meat, fish, eggs) at the age of 6 months is recommended in 30 out of 43 countries, whereas 13 (30%) recommend later introduction. Conclusions: National infant feeding recommendations vary widely between studied countries and partly differ from international recommendations. Too early introduction of complementary feeding can reduce duration of exclusive breast-feeding (EBF). Too late introduction of iron-rich complementary foods might increase anemia risk and adversely affect child development. A review and further harmonization of national recommendations appears desirable.

Adequate nutrition is an important factor for health and well-being in adolescents and later years.Fruits and vegetables are part of a healthy diet as important source of nutrients, but their intakes are lower than the recommendations in European countries. This study aimed to compare the choices made by adolescents and older people between three similar dishes, one based on meat, one on fish and one on vegetables, in two different conditions: a neutral (control) situation and an intervention situation in which the vegetable-based meal was designated 'dish of the day'. The comparisons of choices will be made within the same age group (adolescents in the control group vs. adolescents in the intervention group; older people in the control group vs. older people in the intervention group). A quasi-randomised field trial design was used with a sample of 94 adolescents (aged 10-19 years) and 97 older people (aged 65 years), who were randomly allocated to intervention or control groups. In the control situation participants were asked to choose between three similar meals, one meat, one fish and one the VeggiEat dish. In the intervention, the VeggiEat dish was labelled the 'Dish of the day'. All dishes were provided free of charge, displayed side by side in the same order and served in same portions. The dish choices showed no differences between the control and intervention groups in both age groups, and no differences were found among the other variables analysed. This nudging strategy, 'dish of the day', seems not to work for the Danish sample of adolescents and older people. Future nudging studies with these populations are needed in order to find the best strategy to move adolescents' and older people's food habits toward a healthier pattern. K E Y W O R D Sadolescents, dish of the day, nudging, older people, vegetables consumption

Abstract Identifying a need for developing a conceptual framework for the future development of Food-Based Dietary Guidelines (FBDGs) in Europe, The Federation of European Nutrition Sciences established a Task Force for this purpose. A workshop was held with the specific objective to discuss the various dimensions considered as particularly relevant. Existing frameworks for FBDGs were discussed, and presentations from various countries illustrated several commonalities but also a high degree of heterogeneity in the guidelines from different countries. Environmental aspects were considered in several countries, and dimensions like food safety, dietary habits and preparation were included in others. The workshop provided an overview of the use of FBDGs – both in developing front-of-pack nutrition labels and for reformulation and innovation. The European FBDGs dimensions were described with examples from the close connection between FBDGs and EU policies and activities and from the compilation of a database of national FBDGs. Also, the challenges with communication of FBDGs were discussed. Considering the current scientific basis and the experiences from several countries, the Task Force discussed the various dimensions of developing FBDGs and concluded that environmental aspects should be included in the future conceptual framework for FBDGs. A change in terminology to sustainable FDBGs (SFBDGs) could reflect this. The Task Force concluded that further work needs to be done exploring current practice, existing methodologies, and the future prospects for incorporating other relevant dimensions into a future FENS conceptual framework for SFBDGs in Europe and working groups were formed to address that.

Post-transplant diabetes mellitus (PTDM) is associated with a higher risk of adverse outcomes. We aimed to describe the proportion of patients with diabetes prior to solid organ transplantation (SOT) and post-transplant diabetes mellitus (PTDM) in three time periods (early-likely PTDM: 0–45 days; 46–365 days and >365 days) post-transplant and to estimate possible risk factors associated with PTDM in each time-period. Additionally, we compared the risk of death and causes of death in patients with diabetes prior to transplant, PTDM, and non-diabetes patients. A total of 959 SOT recipients (heart, lung, liver, and kidney) transplanted at University Hospital of Copenhagen between 2010 and 2015 were included. The highest PTDM incidence was observed at 46–365 days after transplant in all SOT recipients. Age and the Charlson Comorbidity Index (CCI Score) in all time periods were the two most important risk factors for PTDM. Compared to non-diabetes patients, SOT recipients with pre-transplant diabetes and PTDM patients had a higher risk of all-cause mortality death (aHR: 1.77, 95% CI: 1.16–2.69 and aHR: 1.89, 95% CI: 1.17–3.06 respectively). Pre-transplant diabetes and PTDM patients had a higher risk of death due to cardiovascular diseases and cancer, respectively, when compared to non-diabetes patients.